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Ilves grew up in Tallinn and graduated from Saku Gymnasium in 1986. In 1993 she received a bachelor's degree in medicine from Tartu University. In 2004 she married her longtime partner Toomas Hendrik Ilves with whom she has one daughter Kadri Keiu (born 2003). In 2005 she began a business project of developing a guesthouse in Ärma farm, located in Abja Parish, that has belonged to her husband's ancestors since the 18th century.

In her professional life, Ilves has worked in advertising and public relations; she was marketing director of the newspaper Eesti Päevaleht from 1996 to 2001. From 2001 to 2002, she worked for Enterprise Estonia, leading the Brand Estonia project which developed the widely used slogan and logo Welcome to Estonia.[2]

As First Lady, Ilves has championed a number of initiatives supporting children, health, and the advancement of women. She has taken part in state visits abroad, such as to Sweden in January 2011.[3]

On 22 August 2014, footage of Mrs. Ilves apparently carousing with a younger male at a well-known open roofed cafe in Tallinn appeared in the Estonian media. The couple appeared to embrace and kiss.[4] Mrs. Ilves later responded on her own Facebook page, requesting forgiveness from those she had hurt.[5][6]

Two days later it was reported that Mrs. Ilves had left Estonia for Germany with her daughter.[7]

Some days later Mrs. Ilves' consort was named as one Vincent Aranega, allegedly a French national.[8]